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Variation in clinical care associated with weekend admission and discharge in psychiatric inpatient units

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  • معلومة اضافية
    • بيانات النشر:
      Cambridge University Press
    • الموضوع:
      2020
    • Collection:
      Imperial College London: Spiral
    • نبذة مختصرة :
      Background Questions have been raised regarding differences in the standards of care that patients receive when they are admitted to or discharged from in-patient units at weekends. Aims To compare the quality of care received by patients with anxiety and depressive disorders who were admitted to or discharged from psychiatric hospital at weekends with those admitted or discharged during the ‘working week’. Method Retrospective case-note review of 3795 admissions to in-patient psychiatric wards in England. Quality of care received by people with depressive or anxiety disorders was compared using multivariable regression analyses. Results In total, 795 (20.9%) patients were admitted at weekends and 157 (4.8%) were discharged at weekends. There were minimal differences in quality of care between those admitted at weekends and those admitted during the week. Patients discharged at weekends were less likely to be given sufficient notification (48 h) in advance of being discharged (OR = 0.55, 95% CI 0.39–0.78), to have a crisis plan in place (OR = 0.65, 95% CI 0.46–0.92) or to be given medication to take home (OR = 0.45, 95% CI 0.30–0.66). They were also less likely to have been assessed using a validated outcome measure (OR = 0.70, 95% CI 0.50–0.97). Conclusions There is no evidence of a ‘weekend effect’ for patients admitted to psychiatric hospital at weekends, but the quality of care offered to those who were discharged at weekends was relatively poor, highlighting the need for improvement in this area.
    • ISSN:
      2056-4724
    • Relation:
      BJPsych Open; http://hdl.handle.net/10044/1/82335
    • الرقم المعرف:
      10.1192/bjo.2020.88
    • الدخول الالكتروني :
      http://hdl.handle.net/10044/1/82335
      https://doi.org/10.1192/bjo.2020.88
    • Rights:
      © 2020 The Author(s). Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/ licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. ; http://crea tivecommons.org/licenses/by/4.0/
    • الرقم المعرف:
      edsbas.DAE8DC29